Echocardiography

I am now on a short echocardiography rotation. Echocardiography is a burgeoning tool that uses ultrasound to look at the heart. Transthoracic echocardiograms are commonly done in general medicine; a sonographer applies the probe to the chest to look at the heart's chambers, valves, and other parameters. This can guide diagnosis and therapy by helping the clinician understand how well the heart is squeezing, look for past heart attacks, measure pressures in the lungs, and grade the severity of diseased valves.

Transesophageal echocardiography uses the same modality but in a different manner. The ultrasound probe is placed into the esophagus in a sedated patient, and this allows the clinician to look at the heart from behind. It is better at assessing certain disease states like infected valves or clots in the atria, but it can also be used by an anesthesiologist during a surgery.

I am currently on a rotation designed to teach anesthesia residents how to place the probe, obtain basic views, and interpret them to guide our intraoperative management. I tag along in all the cardiac rooms where transesophageal echocardiography is a staple. I've seen lots of fascinating pathology: a valve the surgeon wants to replace, a bypass for a poorly functioning heart, a tumor in the atrium. Videos, a simulator, and a textbook round out my learning. It's a really fun, useful, and interesting experience.

Image of echocardiographic image is in the public domain, from Wikipedia.